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COVID-19 detected in United States

ghost

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Where are you seeing a drop in cases for AL? I haven't really seen a drop in cases yet, at least from a statewide average. There's a clear decrease across S Alabama.

Alabama is really a tale of two states at the moment, at least in the hospitalization data. Southern Alabama is falling quickly, while northern Alabama has continued to increase. For the last few weeks they've offset each other, and because of that the # hospitalized statewide has been roughly steady. Northern AL is following along closely with Tennessee's pattern, while southern AL is following with Florida/LA/MS.
Screen Shot 2021-09-09 at 11.39.05 AM.png
 

Jacob

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I believe they are using the "date of test" as opposed to "date of report" dataset. It's the best way to view it in review/post surge, but it can give you a false sense of the direction because the most recent week or two still has to fill in. Unfortunately the date of report for Alabama is so tainted because of data dumps and other things, that it can be difficult to decipher as well. It does look like in both though we may have formed a peak sometime perhaps about two weeks ago.
 

Jacob

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Seems pretty clear we're not going to see the rapid decline from peak that other countries and areas have had with Delta. It's going to be a long Fall and Winter since there's such a high baseline in the Southeast and the United States as a whole - especially, in light of the low vax rates in the Southeast.

So it's been just over two weeks since we had a short discussion on this, so I thought I'd bring it back up. I see some reasons to be optimistic about where this current wave is headed, but I still share some of your more pessimistic concerns as we head into fall.

My reasons to be optimistic are how the numbers are moving in the deep south. This wave is collapsing across all the hardest hit areas that have peaked. I wasn't as confident in this two weeks ago when we discussed this, but hospitalizations and cases have been falling rapidly in Florida, Louisiana, Mississippi, southern AL.
  • The Baptist hospital system in Jacksonville is down to 240 hospitalized patients, it had been as high as 584 on August 8th.
  • The Jackson Hospital System in Miami is down to 270 patients from 404 in the past two weeks.
  • Mobile County (as of Friday the 9th) is down to 275 patients from 486 on August 17th
  • Mississippi (as of Friday the 9th) is down to 1177 patients from 1667 on August 19th
  • Cases in Florida and MS peaked a couple weeks back and are falling quickly now.
  • Hospital admissions are falling quickly in FL/MS/LA as well, see the graphic below
image.png


Reasons I'm still pessimistic: It's already September 13th, by this time last year the fall wave was beginning its increase across the northern US. While the Deep South is rolling over pretty hard, many areas have very high spread currently and either are just getting to peak (TN, GA, SC, KY), or haven't quite peaked yet (some/many northern states) from this wave. If we start seeing a seasonal stimulus across much of the northern US, we'll be starting from a substantially higher baseline than we did a year ago. I think based on current trends the south can probably decline back to similar levels to before last year's wave, but not sure about the rest of the country.

It is worth noting that areas across the north where the Fall 2020 wave really ramped up initially (Minnesota, Dakotas, Montana) are seeing decreasing values of R0, where last year it was very clearly increasing. This could just be noise/a small fall from a summer Delta peak before the fall wave really gets moving. Should have a better idea there by the first of October.
 
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Jacob

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Alabama is now showing a decrease in hospitalizations and is showing a pretty good decrease in admissions as well. North Alabama appears to be past peak now in hospitalization data, which is what is allowing the statewide totals to show decreases now.

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Derek00

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My parents ended up catching this at their church, a church primarily composed of anti-vaxxers and anti-maskers. The doctor flat-out told them they would have not made it if they weren't vaccinated due to their preexisting conditions.

I'm at the point to where I honestly loathe these anti-science idiots. In a perfect world, they would be the only ones getting sick from this. It's so incredibly sad that it is 2021 and this level of stupidity exists on this planet.
 

maroonedinhsv

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My parents ended up catching this at their church, a church primarily composed of anti-vaxxers and anti-maskers. The doctor flat-out told them they would have not made it if they weren't vaccinated due to their preexisting conditions.

I'm at the point to where I honestly loathe these anti-science idiots. In a perfect world, they would be the only ones getting sick from this. It's so incredibly sad that it is 2021 and this level of stupidity exists on this planet.
How many of the people from the church died?
 

Jacob

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There's some truth in that, but hospitalization numbers are primarily decreasing because when somebody dies or gets discharged, there aren't nearly as many new people coming into the hospital. Deaths are always going to contribute on some level to the decreasing numbers, that isn't unique to this wave. Thankfully cases and new admissions are decreasing quickly.

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ghost

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What are everyone's thoughts on the current status of Covid in the US and Alabama and what do ya'll thing will happen in a few weeks as we transition from fall to winter?
 

Jacob

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What are everyone's thoughts on the current status of Covid in the US and Alabama and what do ya'll thing will happen in a few weeks as we transition from fall to winter?

Honestly, I'm not sure what to expect. Last year by this time it was obvious across the northern US that the fall wave was getting ready to explode. R0 estimates show it pretty clearly that spread was above 1 and increasing in the majority of the US, and the most in the northern states. R0 estimates for Sept 20, 2020 shown below

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Compare that to the latest estimate of where we are currently, and you can see that across the vast majority of the country currently COVID is contracting.

image.png


The only areas that are seeing R0 values much above one at the moment are parts of the Upper Midwest and parts of New England. That's actually the southern Delta wave that spread north across the rest of the country, and not a separate northern wave forming (hopefully). It could be a bit of both, but so far it doesn't appear to be a new wave ramping up. This summer wave was displaced by a month compared to last year's, so we might see something similar this fall.

Note: that's simply a map of R0, it hides the fact that COVID is much more prevalent across the country currently than it was this time last year. 7 Day Average cases currently are around 135k, they were around 40k this time last year. That's the other big concern if we get a big surge up north is how high of a base it could be starting from.

As for the south, I'm cautiously optimistic about areas that were hit hard the last couple months. A LOT of people in the south caught COVID this go around. Anecdotally, it seems like everybody knows a lot more people that got it this go around than the winter wave. It'll be real interesting to see what places like Florida, Alabama (particularly southern AL), MS, and LA over the next couple of months, as there's a very high level of immunity present now. All of the deep south is in free fall at the moment, and hopefully it can reach pre-wave depths or deeper before we get a fall/winter stimulus here.

On a similar note to the south, India is a very interesting test case that hasn't gotten much discussion lately. Many areas that had Delta blow through there in April have had COVID all but disappear over the last few months. Uttar Pradesh had a 5 day average case rate of over 20k for a month, and peaked around 35k 5 day average in late April. Their current 5 day average number of cases is....13. I know things are different there and they have a different levels of testing and such, but that's a reduction in detected case rate of 99.96%.
 

Jacob

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On a related note, I've posted before that I think the disappearance of the flu is almost entirely due to viral interference, and has almost nothing to do with NPIs. India's data would currently seem to support that theory. After their massive COVID wave earlier this year retreated, our old friend came back there for the first time.

The image below isn't labelled, but it is for India.

image.png
 

Jacob

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Good news for parts of Alabama, as the fall continues to be steep and quick. Much of the Mobile area is now at less hospitalized patients than this time last year, and at the current rate will be back near May/June lows in another couple weeks. North Alabama is a couple weeks behind, but hospitalization numbers are falling quickly now everywhere across the state. UAB is down to 54 patients from a high of 175, Huntsville Hospital's system is down to 275 from 428. With cases falling quickly everywhere and R(t) estimates well below 1, those numbers should continue to fall quickly.

Here's a graphic from Infirmary Health in southern AL showing how much they've fallen in the last few weeks.

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Jacob

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One system I've been following during this summer wave is the Jackson Health System in the Miami area. I went back and grabbed their data back to last summer to compare the two summer waves, and noticed that south Florida didn't really have a winter wave. Just two very large summer waves. Just thought that was interesting

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ghost

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Case have been dropping significantly in the south and on the Atlantic coast and the NE.. but across the northern border, form Wisc to Washington Covid is still thriving. Has the delta variant just now reached these areas?
 

Jacob

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Case have been dropping significantly in the south and on the Atlantic coast and the NE.. but across the northern border, form Wisc to Washington Covid is still thriving. Has the delta variant just now reached these areas?

Yeah that's the summer delta wave expanding into those areas. You can see on that on the gif below of infections. Many of the northern states have an estimated Rt below 1 at the moment and dropping, so it appears to be peaking/decreasing across much of the northern US *at the moment*. This is the time of year that those states started to explode last year, but for now that seasonal stimulus hasn't seemed to kick in yet.

ezgif-com-gif-maker-4.gif
 

Jacob

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I hope and pray the peak is here, however, most school in Bama started last week and since the variant affects children and they can be super-spreaders, I worry this is just the start!!
What do y’all think?
If we truly peak and start to fall, school resuming would likely be little more than noise in the signal. There was a lot of noise about what Thanksgiving/Christmas/New Years would do back during the winter wave, and for areas that were already post-peak and falling, they continued to fall at roughly the same rate.

I think schools could enhance a few local clusters, but I don't think it'll be a major driver over the overall pattern.

I saw some numbers from Florida today that reminded me of this. Fortunately it appears schools opening had very little overall affect on this COVID wave. Florida saw pediatric cases peak the first week schools opened, and now ~6 weeks into the school year, pediatric cases in Florida have declined over 85%.
 

thundersnow

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Yeah that's the summer delta wave expanding into those areas. You can see on that on the gif below of infections. Many of the northern states have an estimated Rt below 1 at the moment and dropping, so it appears to be peaking/decreasing across much of the northern US *at the moment*. This is the time of year that those states started to explode last year, but for now that seasonal stimulus hasn't seemed to kick in yet.

ezgif-com-gif-maker-4.gif
That’s a fascinating animation.

What’s with Nebraska and Utah, etc., I wonder? I assume the same data used was not available from those areas to produce this.
 

ghost

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Got my booster late this afternoon. Got it on Friday so that if it makes me feel like crap tomorrow... I won't have anything to do but lay on the couch and watch football games
 

ghost

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So will there be another surge after Thanksgiving through the winter? If so... Will it be a new variant?
 
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